After members of Congress and the public expressed outrage at Mylan over its 8-year 600% price increase for the EpiPen, the company proposed a seemingly helpful solution: It offered patients coupons worth up to $300 to cover part of their out-of-pocket costs (1). Such copay assistance seems like a boon for public health, but it is actually a recipe for higher health care costs in the future.

In recent years, drug spending has been one of the fastest growing sectors of health care (2). The amount patients pay out-of-pocket for drugs has also grown rapidly (3). The 2 are related: As drug companies raise medication prices, insurance companies peel back coverage. Although pharmaceutical companies could directly alleviate the financial burden patients are facing by lowering their products' prices, they often choose Mylan's strategy instead. They offer coupons to offset patients' costs or form charities to administer support programs for patients with government insurance (which prohibits direct copay assistance) (4).